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121.
Chemoprevention refers to suppression or reversal of the carcinogenic process using pharmacologic or nutritional agents. Colorectal
carcinogenesis is a protracted, multistep process that offers opportunities for prevention. Aspirin and selective cyclooxygenase-2
inhibitors (coxibs) have been evaluated for the prevention of sporadic adenoma recurrence. Aspirin was shown to reduce adenoma
recurrence rates in patients with prior colorectal neoplasms; however, the optimal dosage remains unclear. Recent studies
of coxibs indicate that these agents are effective in reducing sporadic adenoma recurrence, but chronic use can result in
serious cardiovascular toxicity. These data underscore the need for chemopreventive agents with acceptable risk-to-benefit
ratios. In this regard, nitric-oxide-releasing aspirin shows chemopreventive efficacy in preclinical models and holds promise
for reduced toxicity in humans. Furthermore, ongoing chemoprevention trials are evaluating nutritional supplements, such as
folic acid and selenium, and results are eagerly awaited. 相似文献
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Priv.-Doz. Dr. Rüdiger Dissmann Joachim Schröder MD PhD Prof. Dr. med. Heinz Völler Prof. Dr. med. Steffen Behrens 《Clinical research in cardiology》2006,95(4):241-243
Summary During pacemaker implantation in a patient with permanent atrial fibrillation, it remained impossible to advance a passive
fixation lead with fins through the right atrium. However, a lead with a retractable screw easily passed the right atrium
and was positioned in the right ventricle. Transesophageal echocardiography revealed an extensive net–like perforated Eustachian
valve within the right atrium that had caused entrapment of the anchor fins during lead implantation. Remnants of embryonal
structures within the right atrium should be considered a rare possible barrier during pacemaker implantation. 相似文献
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Noninvasive Intracranial Cerebral Flow Velocity Evaluation in the Emergency Department by Emergency Physicians 总被引:2,自引:0,他引:2
Michael Shafé MD Michael Blaivas MD RDMS Edmond Hooker MD Leigh Straus BS 《Academic emergency medicine》2004,11(7):774-777
Transcranial Doppler (TCD) is an accepted modality for the evaluation of cerebral blood flow velocities. OBJECTIVES: The purpose of this study was to test the feasibility of bedside TCD measurement in the emergency department (ED) with critically ill, intubated patients. METHODS: A prospective convenience sample of patients presenting to a university hospital over a two-month period underwent TCD evaluation of the middle cerebral artery. Intubated patients with head trauma and any patient requiring tracheal intubation were eligible. A 2-MHz Doppler probe was positioned over the temporal bone to acquire blood flow velocities. An emergency medicine resident and research assistant obtained measurements. Continuous TCD tracings were recorded on a video cassette recorder tape for quality assurance review and data collection. Vital signs and therapeutic interventions were also recorded. Flow velocities were measured in cm/s; the peak Resistance Index (RI) was calculated for each patient. RESULTS: A total of 30 patients were enrolled in the study. Adequate tracings were obtained in 25 patients (83%) without a disruption of resuscitation. Tracings could not be obtained in five patients; they were listed as TCD failures. However, in two of these patients, adequate flow velocity tracings were obtained after resuscitation. Four patients were evaluated during tracheal intubation. One patient was monitored successfully during cardiopulmonary resuscitation. The median time required for data acquisition was 1.9 minutes. The mean highest RI for those who expired was 0.84. For those who survived, the mean highest RI was 0.52. The difference of 0.32 was statistically significant (p = 0.04). CONCLUSIONS: Noninvasive blood flow velocity monitoring of the middle cerebral artery using TCD is feasible in the ED when performed at the bedside on intubated patients with traumatic brain injury and others during tracheal intubation and resuscitation. 相似文献